Isometric gluteus medius activation
Isometric gluteus medius activation with step stance bridge
Isometric gluteus medius activation with bridge.
Often in hip dysplasia, we see an over dominance of the tensor fascia lata (TFL) muscle, which becomes hypertrophied over the anterograde-lateral hip. This muscle tends to stabilize the hip and pelvis instead of the gluteus medius, highlighting the need for effective hip dysplasia exercises for adults to address this imbalance.
During a PAO, the external obliques and rectus femoris are reflected off the pelvis, which may result in TFL becoming more dominant post-operatively. This shift can lead to secondary issues such as gluteal tendinopathy, TFL muscle spasm, and psoas irritation, as well as increased anterior shearing of the joint—further emphasizing the importance of hip dyslocation exercises.
Disclaimer: The following are example exercises aimed at activating the gluteus medius muscle, especially beneficial for those seeking hip dysplasia exercises in adults. Ensure that if you are a post-operative PAO patient, you adhere to the weight bearing status advised by your surgeon.
Reference: Sandell Jacobsen et al, 2018 'Muscle–tendon-related abnormalities detected by ultrasonography are common in symptomatic hip dysplasia,' Archives of Orthopaedic Trauma and Surgery, 138 (8) pp. 1059-1067.
Exercise:
Lying down with knees bent and shoulder width apart.
Belt around the top of the knees.
Place thumbs onto the front/lateral side of hips and fingers onto the back pocket area—behind the hip bone.
Gently squeeze your knees out into the belt, like slowly turning the button up on a radio. You should feel the back pocket area gently activate, but not see any movement in TFL under your thumbs.
NB: This is a gentle activation exercise, not a movement exercise, making it suitable for those incorporating hip dysplasia exercises for adults into their rehabilitation.
Isometric gluteus medius activation with bridge.
Isometric gluteus medius activation with step stance bridge
Isometric gluteus medius activation with bridge.
Lying on your back with knees bent, place a belt around your knees and gently squeeze out as per the first exercise, activating the gluteus medius. This is one of the effective hip dysplasia exercises for adults to improve muscle engagement. Slowly push through your heels to raise your pelvis towards the ceiling, ensuring that you keep your hip bones level; hold this position for 5 seconds. Throughout the movement, maintain the activation into the belt while going up and down.
Note: You will feel a stretch over the front of the thigh; this is normal during hip dysplasia exercises for adults.
If you experience cramping in your hamstrings, it indicates that your gluteus muscles are not working sufficiently to lift you up. To engage your glutes effectively and reduce hamstring involvement, bring your heels closer to your bottom. This is particularly important for those incorporating hip dislocation exercises into their rehabilitation.
Disclaimer: These are example exercises to aid activation of the gluteus medius muscle. If you are a post-operative PAO patient, please ensure that you adhere to the weight-bearing status advised by your surgeon.
Isometric gluteus medius activation with step stance bridge
Isometric gluteus medius activation with step stance bridge
Isometric gluteus medius activation with step stance bridge
Progression of the last two hip dysplasia exercises for adults:
Lying on your back with your knees bent, position the foot of the leg you want to work more closely to your bottom, while placing the other foot slightly forward to create a step stance. Use a belt around your knees and gently squeeze outward, activating the gluteus medius, which is essential in hip dislocation exercises.
Slowly push through your heels to raise your pelvis towards the ceiling, ensuring your hip bones remain level, and hold this position for 5 seconds. Maintain the activation into the belt throughout the movement, both on the way up and down.
Note: It’s normal to feel more activation in the hamstring of the leg that is positioned more forward during these hip dysplasia exercises in adults.
Disclaimer: These are example exercises to aid in the activation of the gluteus medius muscle. If you are a post-operative PAO patient, please adhere to the weight-bearing status advised by your surgeon.
Sliders
Non-impact exercise for conservative management
Isometric gluteus medius activation with step stance bridge
Sliders are an effective method for teaching the static aspect of hip dysplasia exercises for adults, particularly in focusing on the gluteus medius in an isometric position while controlling the pelvis. This is crucial for stabilizing the pelvis during gait, especially in the context of hip dislocation exercises.
Exercise:
In this exercise, the static leg works hardest, even though it is not the sliding leg.
1. Stand in a mini squat position to ensure that the TFL cannot engage.
2. Lean your elbows onto a stable surface.
3. Place a sock, a plastic bag, or a slider under the foot of the leg you want to target.
4. Gently slide the foot out to the side and slightly backward, ensuring that the pelvis remains completely still and the knee does not rise or fall.
5. If performed correctly, you should feel a burning or aching sensation in the back pocket area of the static leg.
6. Aim to increase the duration you can maintain this position, for example, from 30 seconds to 1 minute.
Note: The distance the sliding leg moves is not important; the key is to keep the pelvis stable throughout the exercise, which aligns with the principles of hip dysplasia exercises adults should consider.
Disclaimer: These exercises are examples designed to aid the activation of the gluteus medius muscle. If you are a post-operative PAO patient, please adhere to the weight-bearing guidelines provided by your surgeon.
Proprioceptive work on unstable surfaces
Non-impact exercise for conservative management
Non-impact exercise for conservative management
The Berlin bed rest study in 2003 highlighted that prolonged bed rest leads to atrophy of deep stabilising muscles, such as the gluteus medius and minimus, while the more superficial muscles are less affected. As a result, after prolonged bed rest, the body is more likely to recruit these superficial muscles to perform functional tasks, which is particularly relevant when considering hip dysplasia exercises for adults. To counteract this effect, completing rehabilitation on unstable surfaces, such as the Bosu ball or wobble cushion, can help increase the recruitment of deep stabilisers, which is vital in hip dislocation exercises.
Exercises:
- Wobble cushion: double leg balance, squats, balance with eyes closed; only progress to single leg balance if there is no pelvic drop or trunk sway.
- Bosu ball: double leg balance, deadlifts, squats with feet slightly turned out, squats with a weighted ball/bar, and sumo deadlifts (feet slightly turned out) with minimal weight, incorporating upper limb weights while maintaining double leg balance.
Disclaimer: These are example exercises to aid in the activation of the gluteus medius muscle. Ensure that if you are a post-operative PAO patient, you adhere to the weight-bearing status advised by your surgeon, especially when engaging in hip dysplasia exercises adults.
Non-impact exercise for conservative management
Non-impact exercise for conservative management
Non-impact exercise for conservative management
The hip joint experiences approximately 8 times the forces of body weight during impact-based exercise. If you are looking to conservatively manage your hip dysplasia, I recommend reducing impact-based exercise and focusing significantly on non-impact control work, which can be beneficial for hip dysplasia exercises for adults.
Swimming is excellent for cardiovascular fitness and provides a full-body workout. Pilates, both mat work and reformer Pilates, is effective in controlling the lumbopelvic segment and improving core stability, which is crucial for managing hip dysplasia in adults.
For cycling, such as spinning, I advise patients to maintain a stable position either up or down in the saddle and to inform the instructor that you will not be jumping to certain beats. This helps to avoid overactivity of the TFL and anterior shearing on the hip joint. Everything you do should emphasize control.
Ballet barre workouts have proven to be immensely helpful for activating the gluteus medius, aiding in pelvis stabilization. If you notice the TFL overworking on your standing leg, a slight flexion of the trunk and knee can help alleviate that issue.
Incorporating free body weights, particularly upper limb exercises while standing on a Bosu ball, engages the deep stability system and the core, aligning with effective hip dislocation exercises.
Disclaimer: These exercises are examples to aid in the activation of the gluteus medius muscle. If you are a post-operative PAO patient, please adhere to the weight-bearing status advised by your surgeon.